U.S. blacks, gay and straight, have biggest struggle with HIV

An AIDS patient receives his medication at Broadway House for Continuing care in Newark. (Mike Segar/Reuters)

By Julie Steenhuysen and Susan HeaveyReuters

3:32 a.m. EDT, July 23, 2012

CHICAGO/WASHINGTON (Reuters) - As a gay black man growing up in Chicago's infamous Cabrini Green public housing project, Arick Buckles knows first-hand how the stigma of HIV can keep people infected with the virus from seeking treatment.

It took him six years after he tested positive for the human immunodeficiency virus, or HIV, to get care. By then, Buckles was frail and wore turtleneck sweaters to hide his severely swollenlymph nodes.

"I didn't want to accept it was the HIV that was disfiguring my face, my neck. It was visible," Buckles said. He finally sought care after suffering pneumocystispneumonia, a lung infection that strikes HIV patients as their immune systems weaken.

The predominantly black housing project where Buckles grew up was such a hub of crime and poverty that the city tore it down several years ago.

"We thought growing up in Cabrini Green that it was a gay disease. If I were to disclose my status, I felt my homosexuality would be outed," said Buckles, 40, who was so fearful of that prospect that he kept his HIV status, and his sexual orientation, in the closet.

"It's looked upon as disgraceful" in the black community, he said.

Buckles' tale is still too common, despite widespread U.S. efforts to foster awareness of the virus that causes AIDS and its treatment over the last three decades, says Dr. Kevin Fenton, director of the National Center for HIV/AIDS Prevention at the U.S. Centers for Disease Control and Prevention (CDC).

"Stigma is a huge issue," Fenton said. It can keep people from getting tested, and for those who know they are HIV positive, it can keep them from getting the treatment they need.

He said stigma affects a broad swath of communities in different forms, but for many blacks in America, it exists on top of poverty, poor access to treatment and poor outreach for effective prevention services.

HIV transmission rates have fallen from 130,000 new infections per year during the epidemic's peak in the mid-1980s to 50,000 a year, a level little changed since the mid-1990s.

Part of the problem is that many Americans are infected and do not know it. Of the estimated 1.1 million Americans living with HIV, nearly one in five of those individuals remain undiagnosed.

Up to 44 percent of new infections are clustered in 12 major cities, including Chicago, Washington, New York and Los Angeles, CDC data show. Within these communities, HIV rates are highest among blacks, Hispanics and gay and bisexual men of all races.

CDC researchers will present the latest U.S. data this week at the International AIDS Society's AIDS 2012 conference in Washington, where scientists will gather to discuss better ways to prevent, treat and seek a cure for the disease.

BLACKS, GAYS AND HIV

According to a report released last week by the Black AIDS Institute, black gay and bisexual men make up one in 500 Americans overall, but account for one in four new HIV infections in the United States.

It found that by the time a black gay man reaches 25, he has a one in four chance of being infected with HIV. By age 40, he has a 60 percent chance of being infected.

Fenton said there is nothing unique about blacks that make them more vulnerable to HIV infection. Once higher infection rates are seen in a community, the chances of new members becoming infected are simply higher.

"What we believe is that the infection is becoming concentrated in these minority groups as a reflection of the social and structural drivers of health inequalities overall," he said.

A CDC study published on Friday in the Lancet medical journal found that black men who have sex with men in the United States are 72 times more likely than the general population to be HIV-positive.